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Topic Contents

Breast Problems

Topic Overview

Breast lumps or changes are a common health worry for most women. Women may have many kinds of breast lumps and other breast changes throughout their lives, including changes that occur with menstrual periods, pregnancy, and aging. Most breast lumps and breast changes are normal.

Breast changes in young girls

Breast development is the first sign of puberty in young girls. Usually, breasts begin as small, tender bumps under one or both nipples that will get bigger over the next few years. It is not unusual for one breast to be larger than the other or for one side to develop before the other. A girl may worry that a lump under the nipple is abnormal or a sign of a serious medical problem when it is a part of normal breast development.

If a woman has breast implants, there could be changes in the implant over time. Normal activity or an injury to the breast can damage the implant, causing it to leak, deflate, or rupture. The implant may harden, develop ripples, shift position, or change shape. The implant may need to be removed and replaced if any of these changes occur.

Breast changes that need follow-up

Many women with breast pain or breast lumps worry about breast cancer.

There are two common methods of early detection:

Mammogram. A mammogram is an X-ray of the breast that can often find tumors that are too small for you or your doctor to feel. Experts do not agree about when or how often women should have mammograms. Some recommend that you begin screening at age 40, and some recommend that you begin screening at age 50. Your doctor may suggest that you have a screening mammogram at a younger age if you have risk factors for breast cancer.

Clinical breast examination (CBE). During your routine physical exam, your doctor may do a clinical breast exam. During a CBE, your doctor will carefully feel your breasts and under your arms to check for lumps or other unusual changes. Talk to your doctor about whether to have a clinical breast exam.

Breast self-examination (BSE) involves checking your breasts for lumps or changes while standing and lying in different positions and while looking at your breasts in a mirror. Once you know what your breasts normally look and feel like, any new lump or change in appearance should be evaluated by a doctor. Most breast problems or changes are not caused by cancer. But BSE should not be used in place of clinical breast examination and mammography. Studies have not shown that BSE alone reduces the number of deaths from breast cancer.

Early breast cancer is often seen on a mammogram before there are any symptoms. The most common symptom of breast cancer is a painless lump. But sometimes painful lumps are cancerous. Other symptoms of breast cancer include:

Skin changes, such as dimpling or puckering.

Nipple discharge.

Darkening of the area around the nipple.

A nipple being drawn inward.

Any breast problem that lasts more than 2 weeks.

A breast lump in a man.

Breast changes in boys

In men, enlargement of male breast tissue (gynecomastia) is a noncancerous breast change. Breast buds are common in teenage boys during puberty. The buds may last up to 2 years, but they tend to go away within the first year. Breast buds develop because of rapid changes in hormone levels.

Many prescription and nonprescription medicines can cause breast problems, such as breast tenderness or nipple discharge. A few examples are:

Some antidepressants.

Some blood pressure medicines.

Corticosteroids, such as prednisone.

Medicines that contain hormones, such as birth control pills, hormone therapy, and infertility medicines.

Migraine headache medicines, such as sumatriptan.

Cimetidine, such as Tagamet, may cause nipple discharge and breast enlargement in men.

Symptoms of a heart attack may include:

Chest pain or pressure, or a strange feeling in the chest.

Sweating.

Shortness of breath.

Nausea or vomiting.

Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.

Lightheadedness or sudden weakness.

A fast or irregular heartbeat.

The more of these symptoms you have, the more likely it is that you're having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas.

Other breast symptoms to pay attention to can include:

Skin changes, such as dimpling or puckering.

Nipple discharge.

Darkening of the area around the nipple.

A nipple being drawn inward.

Any breast problem that lasts more than 2 weeks.

Symptoms of a breast infection may include:

Increased pain, swelling, redness, or warmth around a breast.

Red streaks extending from a breast.

Drainage of pus from a breast.

Fever.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.

Long-term alcohol and drug problems.

Steroid medicines, which may be used to treat a variety of conditions.

Chemotherapy and radiation therapy for cancer.

Other medicines used to treat autoimmune disease.

Medicines taken after organ transplant.

Not having a spleen.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:

Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.

Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.

Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

Call your doctor today to discuss the symptoms and arrange for care.

If you cannot reach your doctor or you don't have one, seek care today.

Home Treatment

Breast self-exams are a simple way for you to learn what your breasts normally feel like. During a breast self-exam, you examine your own breasts to look and feel for changes from one month to the next. You will learn how your breasts feel and what is normal for you so that you can spot any changes early. For more information about how to do a breast self-exam, see the topic Breast Self-Examination.

If you have pain or a fever from a breast problem or injury, you can try nonprescription medicines for your symptoms.

Aspirin (also a nonsteroidal anti-inflammatory drug), such as Bayer or Bufferin

Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips

Be sure to follow these safety tips when you use a nonprescription medicine:

Carefully read and follow all directions on the medicine bottle and box.

Alternative medicines or supplementsmay help relieve breast tenderness, discomfort, or pain (mastalgia). Some studies have shown that magnesium reduces mild premenstrual symptoms. As with all alternative medicines and supplements, be sure to follow the directions on the label. Do not exceed the maximum recommended dose. If you are or could be pregnant, talk with your doctor before taking any medicine or supplement. For more information, see the topic Fibrocystic Breasts.

Prevention

Wear a sports bra during exercise. A sports bra may prevent breast discomfort, pain, and injury during exercise or sports. It is important that the sports bra fit properly. It should keep the breasts almost motionless and allow them to move together with the chest, not separately. Be sure to replace your sports bra as the material stretches and become less supportive. A sports bra may need to be replaced every 6 months if it is used regularly.

Related Information

References

Other Works Consulted

American Cancer Society (2009). Prevention and Early Detection: American Cancer Society Guidelines for the Early Detection of Cancer. Atlanta: American Cancer Society. Available online: http://www.cancer.org/docroot/PED/content/ped_2_3X_ACS_Cancer_Detection_Guidelines_36.asp.

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